Scleral-Fixated Intraocular Lens: Indications and Results

Abstract

Currently, ideal cataract surgery should end with the placement of an intraocular lens (IOLs) in the bag. However, in the clinical setting we have to manage cases without enough capsular support to allow the physiological IOL placement. Progress has been made in terms of IOL designs and implantation techniques. The options should be analyzed not only in accordance with surgeon's experience but also with patient's age, local, and systemic comorbidities. Thus, in the absence of an appropriate capsule, IOL can be placed in the anterior chamber, fixated to the iris or to the sclera wall. In this paper, the personal experience of one surgeon with ab externo scleral-fixated IOLs is presented, with the aim to outline the place of this surgical technique in the correction of aphakia. A retrospective study was carried out, including 57 patients in which an IOL was fixated to the sclera, throughout January 2015-April 2019. The causes of aphakia, preoperative and postoperative best-corrected visual acuities (BCVA), and intraand postoperative complications are analyzed. Statistical tests were applied in order to draw significance. In most instances, BCVA has remained stable, with no significant complications, making sclera fixation IOL a viable solution in the correction of aphakia.